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Tenecteplase Treatment and Thrombus Characteristics Associated With Early Reperfusion: An EXTEND-IA TNK Trials Analysis by Vignan Yogendrakumar; Leonid Churilov; Prodipta Guha; James Beharry; Peter J. Mitchell; Timothy J. Kleinig; Nawaf Yassi; Vincent Thijs; Teddy Y. Wu; Helen Brown; Helen M. Dewey; Tissa Wijeratne; Bernard Yan; Gagan Sharma; Patricia M. Desmond; Mark W. Parsons; Geoffrey A. Donnan; Stephen M. Davis; Bruce C.V. Campbell; Richard Dowling; Steven Bush; Rebecca Scroop; Mark Brooks; Hamed Asadi; Timothy Ang; Ferdinand Miteff; Christopher Levi; Henry Zhao; Felix Ng; Fana Alemseged; Henry Rice; Laetitia de Villiers; Kendal Redmond; David Leggett is a Medicine article available to read on EtoBox.

What is Tenecteplase Treatment and Thrombus Characteristics Associated With Early Reperfusion: An EXTEND-IA TNK Trials Analysis about?

Background: Intracranial occlusion site, contrast permeability, and clot burden are thrombus characteristics that influence alteplase-associated reperfusion. In this study, we assessed the reperfusion efficacy of tenecteplase and alteplase in subgroups based on these characteristics in a pooled analysis of the EXTEND-IA TNK trial (Tenecteplase Versus Alteplase Before Endovascular Therapy for Ischemic Stroke). Methods: Patients with large vessel occlusion were randomized to treatment with tenecteplase (0.25 or 0.4 mg/kg) or alteplase before thrombectomy in hospitals across Australia and New Zealand (2015–2019). The primary outcome, early reperfusion, was defined as the absence of retrievable thrombus or >50% reperfusion on first-pass angiogram. We compared the effect of tenecteplase versus alteplase overall, and in subgroups, based on the following measured with computed tomography angiography: intracranial occlusion site, contrast permeability (measured via residual flow grades), and clot burden (measured via clot burden scores). We adjusted for covariates using mixed effects logistic regression models. Results: Tenecteplase was associated with higher odds of early reperfusion (75/

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Author

Vignan Yogendrakumar; Leonid Churilov; Prodipta Guha; James Beharry; Peter J. Mitchell; Timothy J. Kleinig; Nawaf Yassi; Vincent Thijs; Teddy Y. Wu; Helen Brown; Helen M. Dewey; Tissa Wijeratne; Bernard Yan; Gagan Sharma; Patricia M. Desmond; Mark W. Parsons; Geoffrey A. Donnan; Stephen M. Davis; Bruce C.V. Campbell; Richard Dowling; Steven Bush; Rebecca Scroop; Mark Brooks; Hamed Asadi; Timothy Ang; Ferdinand Miteff; Christopher Levi; Henry Zhao; Felix Ng; Fana Alemseged; Henry Rice; Laetitia de Villiers; Kendal Redmond; David Leggett

Publisher

Ovid Technologies (Wolters Kluwer Health)

Published

2023

Language

EN

Field

Medicine (Health Sciences)